Oncmergencies
She's My Geri Pie
Take My Breath Away
Extreme Heme
Read My Mind
100
Which of the following is most consistent with tumor lysis syndrome?
A. Increased potassium, urea, bicarb, decreased phosphorus
B. Increased potassium, urea, phosphorus, decreased calcium
C. Increased chloride, calcium, creatinine, decreased potassium
D. Increased bicarb, phosphorus, calcium, decreased potassium
B. Increased potassium, urea, phosphorus, decreased calcium
K -C U P
100
Which of the following is not listed on the 2019 Beers criteria for potentially inappropriate medication use in older adults?
A. Clonidine
B. Quetiapine
C. Lisinopril
D. Metoclopramide
C. Lisinopril
100
When evaluating suspected diffuse parenchymal lung disease, which imaging test should be ordered?
A. High resolution chest CT
B. PA and lateral chest x-ray
C. Standard chest CT
D. Upright and supine chest x-ray
A. High resolution chest CT
100
What is the best initial empiric therapy for a patient with high-risk febrile neutropenia without a source and who is hemodynamically stable.
A. Ciprofloxacin and amoxicillin-clavulanate
B. Cefepime
C. Cefepime, Vancomycin
D. Cefepime, Vancomycin, and Amphotericin B
B. Cefepime
100
What is the best term for the sweet, sticky topping atop your biscuit (or scone) that is made from pureed or crushed fruit and its juice?
A. Marmalade
B. Jam
C. Jelly
D. Fruit Butter
B. Jam
200
All of the following are causes of hypercalcemia in malignancy EXCEPT?
A. Release of PTHrP from malignant cells
B. Bony destruction by the tumor
C. Vitamin D secreting lymphomas
D. Calcitriol binding protein released from pituitary tumors
D. Calcitriol binding protein released from pituitary tumors
200
Which of the following is the least appropriate initial step in the evaluation of a geriatric patient with suspected cognitive impairment?
A. Mini-Cog
B. Apolipoprotein E (APOE-e4) genotyping
C. PHQ-2
D. MMSE
B. Apolipoprotein E (APOE-e4) genotyping
200
Per CDC guidelines, what is the most appropriate scenario to initiate Remdesivir in patients with COVID-19 infections?
A. Ambulatory management of mild cases
B. Hospitalized patients not requiring supplemental oxygen
C. Hospitalized patients requiring supplemental oxygen
D. Hospitalized patients requiring mechanical intubation or ECMO
C. Hospitalized patients requiring supplemental oxygen
200
Which of the following is the most likely cause of acute dyspnea and rigors with fever, hypotension, and hypoxemia with BL infiltrates on CXR immediately following a PRBC transfusion?
A. Transfusion-Associated GVHD
B. Transfusion-Associated Circulatory Overload (TACO)
C. Anaphylactic Reaction
D. Transfusion-Related Acute Lung Injury (TRALI)
D. Transfusion-Related Acute Lung Injury (TRALI)
200
If you logged on to this battle royale on Wednesday you would have been met by copious amounts of zombies (maybe even became one yourself), leading to the map being nuked. If you log on today you find some major alterations to the map. What game is this?
A. Fortnite
B. Battlefield
C. The Last of Us
D. Warzone
D. Warzone
300
28 yo F with HIV presents with headache, N/V. Exam shows papilledema but no other focal findings. CT shows:
What is the next best step?
A. Combination chemotherapy
B. High dose IV steroids
C. ICP monitoring
D. Stereotactic radiation therapy
B. High dose IV steroids
300
A 92-year-old with dementia is experiences urinary incontinence. Her caretaker explains the patient has lost the ability to recognize she needs to urinate, and can only get up from a chair slowly and with assistance. Which of the following is most likely to benefit her?
A. Oxybutynin
B. Pelvic floor muscle training (Kegel exercises)
C. Prompted voiding
D. Sling cystourethropexy
C. Prompted voiding
300
Which of the following is not part of the 2012 Berlin Criteria for diagnosis of acute respiratory distress syndrome?
A. Acute onset of respiratory failure
B. PCWP < 18
C. Bilateral infiltrates on CXR
D. PaO2/FiO2 < 300
B. PCWP < 18
300
A 50 yo woman presents with unexpected menorrhagia, subconjunctival hemorrhage, and abdominal pain. She is alert to person and place but not time. Hct is 26% and Plt is 24,000/uL. Peripheral Smear is seen below.
What is the next best step?
A. Platelet transfusion
B. Plasma exchange
C. Obtain Shiga toxin
D. pRBC transfusion
B. Plasma exchange
300
What is the term for when plant leaves and stems become pale due to lack of sunlight?
A. Cotyledonated
B. Etiolated
C. Adaxialated
D. Tesselated
B. Etiolated
400
72 yo M presents with symptoms of SVC syndrome without stridor or mental status changes. CT shows a 7-cm medial left lung mass and bulky mediastinal lymphadenopathy and superior vena cava compression.
What is the most appropriate management?
A. Biopsy of the lung mass
B. SVC stent
C. Immediate radiation therapy
D. Venography
A. Biopsy of the lung mass
400
Who's this guy?
A. Dylan McDermott
B. Dermot Mulroney
C. Kit McDermott
D. Derbil McDillet
B. Dermot Mulroney
400
81yo M with shortness of breath, fever and cough is found to have a right sided pleural effusion during follow up from a hospital discharge for pneumonia. Thoracentesis is performed which shows WBCs of 22,000/uL, glucose of 40, LDH of 1256, pH of 7.1 and negative gram stain. Which of the following is the most appropriate management?
A. Begin ceftriaxone and azithromycin
B. Insert a large-bore pleural drain and begin levofloxacin
C. Insert a small-bore pleural drain and begin piperacillin-tazobactam
D. Repeat the chest radiograph in 2 weeks
C. Insert a small-bore pleural drain and begin piperacillin-tazobactam
400
A 36-week pregnant female with a history of gestational thrombocytopenia and BP 165/110 has the following lab findings: Hgb 8.5 g/dL, Plt 21,000, AST 250, ALT 300, LDH 2000. What is the most appropriate treatment?
A. Delivery
B. Magnesium
C. Betamethasone
D. Observation with continuous fetal monitoring
A. Delivery
400
The following lines from Edgar Allen Poe's The Raven are written in what poetic meter?
"Once upon a midnight dreary,
While I pondered, weak and weary"
A. Trochaic tetrameter
B. Iambic pentameter
C. Dactylic hexameter
D. Anapestic trimeter
A. Trochaic tetrameter
